Hepatic resection of metastatic tumor from serous cystadenocarcinoma of the ovary.

Metastatic carcinomas are the largest group of malignant tumors of the liver. But parenchymal liver metastasis from cystic ovarian adenocarcinoma is very rare. We report a case in which the resection of metastatic liver neoplasm from ovarian serous cystadenocarcinoma was done 7 yr after initial treatment. A 48-yr-old oriental housewife complained of easy fatigability and right lower quadrant discomfort. The hepatic mass was detected by ultrasonographic examination. Serum albumin, bilirubin, and aspartate aminotransferase/alanine aminotransferase were normal. Alkaline phosphatase level was slightly increased at 146 IU/L. A tumor marker study showed alpha-fetoprotein 0.97 IU/mL, carcinoembryonic antigen 0.965 ng/mL, cancer antigen 125 1,267 ng/mL and CA 19-9 106.1 ng/mL. The operation involved cholecystectomy and segmentectomy VI and VII of the liver. The patient recovered from the surgery without any complication. On the 10th postoperative day, the patient received a single-regimen chemotherapy with paclitaxel (Taxol, 155 mg/m(2) BSA) and was discharged. She has been carefully followed-up without any evidence of recurrence after completion of the remaining 5 cycles of chemo-therapy, at intervals of three weeks

Sedimentary and structural evolution of the Eastern South Korea Plateau (ESKP), East Sea (Japan Sea)

The East Sea (Japan Sea) is a semi-enclosed back-arc basin that is thought to preserve a significant record of tectonic evolution and paleo-climatic changes of Eastern Asia during the Neogene. We use here 2-D regional multi-channel seismic reflection profiles and borehole data from Expedition 346 of the Integrated Ocean Drilling Program (IODP) to provide new constraints on the geological history of the Eastern South Korea Plateau (ESKP). The ESKP represents a structurally-complex basement high in the southwestern East Sea which formed during rifting of the back-arc basin. Our new observations show that the ESKP is composed of numerous horsts and grabens controlled by NE-trending normal faults. The acoustic basement is blanketed by Oligocene to recent sediments that have preferentially accumulated in topographic lows (up to 1.5 km thick) and have been cored during Expedition 346 at Site U1430 close to the southern margin of the ESKP. Seismic profiles in the ESKP reveal three units separated by regional unconformities. These seismic units closely correspond to IODP lithostratigraphic units defined at Site U1430, where biostratigraphic data can be used to constrain the timing of three main evolutionary stages of the ESKP. Stage 1 was related to rifting in the late Oligocene and middle Miocene, terminated by a regional uplift leading to an erosional phase in the middle Miocene. Stage 2 was associated with subsidence in the middle and late Miocene and uplift and accompanying erosion or non-deposition in the latest late Miocene. Stage 3 (Pliocene to present) recorded overall uniform hemipelagic-pelagic subsidence of the ESKP with short-lived tectonically-induced uplifts in the late middle Miocene and latest Miocene-early Pliocene. The three stages of evolution of the ESKP closely correlate to sedimentary changes since the Oligocene and suggest a direct control of regional/local tectonics on sedimentation patterns in the southwestern East Sea, with secondary influence of regional climatic and paleo-oceanographic processes

Exosomes from Human Adipose Tissue-Derived Mesenchymal Stem Cells Promote Epidermal Barrier Repair by Inducing de Novo Synthesis of Ceramides in Atopic Dermatitis.

Atopic dermatitis (AD) is a multifactorial, heterogeneous disease associated with epidermal barrier disruption and intense systemic inflammation. Previously, we showed that exosomes derived from human adipose tissue-derived mesenchymal stem cells (ASC-exosomes) attenuate AD-like symptoms by reducing multiple inflammatory cytokine levels. Here, we investigated ASC-exosomes' effects on skin barrier restoration by analyzing protein and lipid contents. We found that subcutaneous injection of ASC-exosomes in an oxazolone-induced dermatitis model remarkably reduced trans-epidermal water loss, while enhancing stratum corneum (SC) hydration and markedly decreasing the levels of inflammatory cytokines such as IL-4, IL-5, IL-13, TNF-α, IFN-γ, IL-17, and TSLP, all in a dose-dependent manner. Interestingly, ASC-exosomes induced the production of ceramides and dihydroceramides. Electron microscopic analysis revealed enhanced epidermal lamellar bodies and formation of lamellar layer at the interface of the SC and stratum granulosum with ASC-exosomes treatment. Deep RNA sequencing analysis of skin lesions demonstrated that ASC-exosomes restores the expression of genes involved in skin barrier, lipid metabolism, cell cycle, and inflammatory response in the diseased area. Collectively, our results suggest that ASC-exosomes effectively restore epidermal barrier functions in AD by facilitating the de novo synthesis of ceramides, resulting in a promising cell-free therapeutic option for treating AD

Patient Descriptions of Rectal Effluents May Help to Predict the Quality of Bowel Preparation With Photographic Examples

Background/AimsPrevious studies have suggested a weak correlation between self-reported rectal effluent status and bowel preparation quality. We aim to evaluate whether photographic examples of rectal effluents could improve the correlation between patient descriptions of rectal effluents and bowel preparation quality.MethodsBefore colonoscopy, patients were asked to describe the nature of their last three rectal effluents. Photographic examples of rectal effluents were provided as a reference for scoring. Bowel preparation was subsequently assessed by a single endoscopist using a global preparation assessment scale. Preparation outcomes were grouped into two levels (excellent to good vs. fair to inadequate). Both univariate and multivariate logistic regression models were used to find any association between bowel preparation quality and patient characteristics.ResultsA total of 138 patients completed the questionnaires. The mean age was 56.5±10.4 years. The mean sum of the last three rectal effluent scores was 5.9±2.0. Higher rectal effluent scores (odds ratio [OR], 0.82; P=0.043) and the presence of diverticula (OR, 0.16; P<0.001) were risk factors for suboptimal preparation.ConclusionsPhotographic example-guided patient descriptions of rectal effluents showed a statistically significant association with bowel preparation quality. However, clinical significance seemed to be low. The presence of diverticula was an independent predictive factor for suboptimal bowel preparation quality

Change in the diagnosis of inflammatory bowel disease: a hospital-based cohort study from Korea

Background/AimsAccurately diagnosing inflammatory bowel disease (IBD) remains a challenge, but is crucial for providing proper management for affected patients. The aim of the present study was to evaluate the frequency of change in diagnosis in Korean patients who were referred to our institution with a diagnosis of IBD.MethodsWe enrolled 1,444 patients diagnosed with ulcerative colitis (UC) and 1,452 diagnosed with Crohn's disease (CD), who had been referred to the Asan Medical Center between January 2010 and December 2014. These patients were assessed and subsequently classified as having UC, CD, indeterminate colitis, possible IBD, or non-IBD.ResultsDuring a median follow-up of 15.9 months, 400 of the 2,896 patients (13.8%) analyzed in this study experienced a change in diagnosis. A change in diagnosis from UC to CD, or vice-versa, was made in 24 of 1,444 patients (1.7%) and 23 of 1,452 patients (1.6%), respectively. A change to a non-IBD diagnosis was the most common modification; 7.5% (108 of 1444) and 12.7% (184 of 1452) of the patients with a referral diagnosis of UC and CD, respectively, were reclassified as having non-IBD. Among the 292 patients who were ultimately determined not to have IBD, 135 (55 UC and 80 CD cases) had received IBD-related medication.ConclusionsThere are diagnostic uncertainties and difficulties in relation to IBD. Therefore, precise assessment and systematic follow-up are essential in the management of this condition

Pyruvate Dehydrogenase Kinase Is a Metabolic Checkpoint for Polarization of Macrophages to the M1 Phenotype

Metabolic reprogramming during macrophage polarization supports the effector functions of these cells in health and disease. Here, we demonstrate that pyruvate dehydrogenase kinase (PDK), which inhibits the pyruvate dehydrogenase-mediated conversion of cytosolic pyruvate to mitochondrial acetyl-CoA, functions as a metabolic checkpoint in M1 macrophages. Polarization was not prevented by PDK2 or PDK4 deletion but was fully prevented by the combined deletion of PDK2 and PDK4; this lack of polarization was correlated with improved mitochondrial respiration and rewiring of metabolic breaks that are characterized by increased glycolytic intermediates and reduced metabolites in the TCA cycle. Genetic deletion or pharmacological inhibition of PDK2/4 prevents polarization of macrophages to the M1 phenotype in response to inflammatory stimuli (lipopolysaccharide plus IFN-γ). Transplantation of PDK2/4-deficient bone marrow into irradiated wild-type mice to produce mice with PDK2/4-deficient myeloid cells prevented M1 polarization, reduced obesity-associated insulin resistance, and ameliorated adipose tissue inflammation. A novel, pharmacological PDK inhibitor, KPLH1130, improved high-fat diet-induced insulin resistance; this was correlated with a reduction in the levels of pro-inflammatory markers and improved mitochondrial function. These studies identify PDK2/4 as a metabolic checkpoint for M1 phenotype polarization of macrophages, which could potentially be exploited as a novel therapeutic target for obesity-associated metabolic disorders and other inflammatory conditions

Neoamphimedine Circumvents Metnase-Enhanced DNA Topoisomerase IIα Activity Through ATP-Competitive Inhibition

Type IIα DNA topoisomerase (TopoIIα) is among the most important clinical drug targets for the treatment of cancer. Recently, the DNA repair protein Metnase was shown to enhance TopoIIα activity and increase resistance to TopoIIα poisons. Using in vitro DNA decatenation assays we show that neoamphimedine potently inhibits TopoIIα-dependent DNA decatenation in the presence of Metnase. Cell proliferation assays demonstrate that neoamphimedine can inhibit Metnase-enhanced cell growth with an IC50 of 0.5 μM. Additionally, we find that the apparent Km of TopoIIα for ATP increases linearly with higher concentrations of neoamphimedine, indicating ATP-competitive inhibition, which is substantiated by molecular modeling. These findings support the continued development of neoamphimedine as an anticancer agent, particularly in solid tumors that over-express Metnase

The First Korean Experience of Telemanipulative Robot-Assisted Laparoscopic Cholecystectomy Using the da Vinci System

With the advancement of laparoscopic instruments and computer sciences, complex surgical procedures are expected to be safely performed by robot assisted telemanipulative laparoscopic surgery. The da Vinci system (Intuitive Surgical, Mountain View, CA, USA) became available at the many surgical fields. The wrist like movements of the instrument's tip, as well as 3-dimensional vision, could be expected to facilitate more complex laparoscopic procedure. Here, we present the first Korean experience of da Vinci robotic assisted laparoscopic cholecystectomy and discuss the introduction and perspectives of this robotic system

Isolation of anaerobic cellulolytic thermophiles and production and purification of the cellulase from Clostridium thermocellulaseum M-7

An enrichment procedure led to the isolation, by the cellulose roll tube method, of a number of actively cellulolytic anaerobic thermophilic bacteria. Two isolates were terminally sporing rods and were tentatively identified as Clostridium thermocellulaseum (Enebo, 1951). Strain M-7 (0.6 μm x 4.0 μm) from manure grew optimally at 58°C to 63°C, pH 6.0 to 6.5 and did not require organic nitrogen. Strain C-19 (0.3 μm x 4.5 μm) from compost was similar but grew optimally at 50°C to 68°C, pH 7.5. Both utilized cellobiose and a wide range of other sugars. Strain C-19 did not utilize glucose, raffinose and inositol but did use inulin. The mean generation times in a rich nutrient medium containing cellobiose were 35 min for strain M-7 and 25 min for strain C-19. Strain M-7 had a mean generation time of 2 hr when grown on cellulose. Yeast extract (0.5%) stimulated growth and cellulase production by strain M-7 but was inhibitory at higher concentrations. Other organic nitrogen sources acted similarly. Cellulose at 1.0% gave maximum cellulase production after 72 hr incubation of strain M-7. Higher concentrations of cellulose were not completely degraded in 72 hr. Strain M-7 did not produce cellulase when grown on any carbon source other than cellulose substrates. The addition of cellobiose (0.3%) and glucose (0.4%) prevented cellulose hydrolysis in cellulose medium. This may have been repression of synthesis but cellulase was inhibited by both sugars. Both C₁, cellulase (degrades native cellulose) and Cx cellulase (β-1,4-glucanase) activities in strain M-7 cultures were assayed by measuring the liberation of reducing sugars, using dinitrosalicylic acid. Both activities had optima at pH 6.5 and 67°C. Cx cellulase could conveniently be assayed by a new automated procedure. Strain M-7 was very actively cellulolytic when compared to previously microbial species. The 48 hr culture contained Cx activity (56 μg glucose/min/ml from carboxymethyl cellulose) and C₁ activity (8 μg glucose/min/ml from cotton fibres); the ratio of C₁,:Cx was 1:7. The cellulase(s) from strain M-7 were extra-cellular, produced during exponential growth but were not free in the growth medium until 50% of the cellulose was hydrolyzed. Glucose and cellobiose were the only soluble products liberated by the cellulase from cellulose. ZnCl₂ precipitation appeared to be a good method for the concentration of cellulase activity but subsequent purification was not successful. Isoelectric focusing indicated the presence of four Cx cellulases (pI 4.5, 6.3, 6.8, and 8.7). DEAE-Sephadex chromatography indicated three Cx components. It is concluded that C. thermocellulaseum M-7 produces cellulase(s) capable of rapidly hydrolyzing native cellulose. The rapid production and high activity of cellulases from this organism strongly support the basic premise that increased hydrolysis of cellulose is possible at elevated temperature.Science, Faculty ofMicrobiology and Immunology, Department ofGraduat